Li Hejie, Tang Wei, Li Ting, Wang Shanhong, Li Hui, Yun Muqin, Xu Jing, Tan Weilin, Jin Xiaoxia, Huang Hairui, Li Hongyan, Teng Yuanlin, Tian Hongzheng, Zong Shimin, Xiao Hongjun
Department of Otorhinolaryngology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, No. 1277 Jiefang Avenue, Wuhan, 430022, Hubei Province, China.
Department of Rehabilitation for Children with Hearing Impairments, Hubei Disabled Persons' Federation Rehabilitation Center, Wuhan, China.
Sci Rep. 2025 May 10;15(1):16337. doi: 10.1038/s41598-025-01158-0.
This study aims to investigate the impact of cerebral white matter lesions (CWMLs) on auditory, speech, and non-verbal cognitive (NVC) outcomes following cochlear implantation (CI) in children with prelingually sensorineural deafness (PLSND) and to identify prognostic factors for these domains. This province-wide retrospective cohort study included PLSND patients with CWMLs undergoing CI, employing propensity score matching for control. Participants were categorized into four groups based on CWMLs severity for auditory, speech, and NVC assessments at various post-CI intervals. Mixed models were used to analyze prognostic factors. In a cohort of 1163 children with PLSND, 15% exhibited CWMLs. CWMLs patients exhibited poorer pre-CI auditory and reduced post-implantation outcomes, correlated with lesion severity. Recovery patterns varied (auditory: rapid-slow; speech: slow-rapid-slow; NVC: rapid-stable), with speech recovery trailing auditory recovery. Greater severity of CWMLs and elevated pre-CI hearing thresholds are risk factors for poorer post-CI auditory and speech outcomes. Conversely, higher income, enhanced pre-CI auditory and NVC capabilities, prolonged rehabilitation, and cesarean delivery are protective factors for these outcomes. Greater severity of CWMLs served as an independent risk factor for post-CI NVC, while cesarean delivery, strong pre-CI speech capabilities, and Advanced Bionics CI device emerged as independent protective factors. This study highlights the importance of incorporating CWMLs severity, perinatal history, and clinical characteristics into preoperative assessments to refine CI candidacy criteria. The identified recovery patterns further guide personalized rehabilitation strategies, contributing to improved long-term outcomes in children with PLSND.
本研究旨在探讨脑白质病变（CWMLs）对语前感音神经性聋（PLSND）儿童人工耳蜗植入（CI）后听觉、言语和非言语认知（NVC）结果的影响，并确定这些领域的预后因素。这项全省范围的回顾性队列研究纳入了接受CI的患有CWMLs的PLSND患者，并采用倾向得分匹配进行对照。根据CI后不同时间间隔的CWMLs严重程度，将参与者分为四组，进行听觉、言语和NVC评估。使用混合模型分析预后因素。在1163名PLSND儿童队列中，15%表现出CWMLs。CWMLs患者在CI前的听觉较差，植入后结果降低，这与病变严重程度相关。恢复模式各不相同（听觉：快-慢；言语：慢-快-慢；NVC：快-稳定），言语恢复落后于听觉恢复。CWMLs更严重和CI前听力阈值升高是CI后听觉和言语结果较差的危险因素。相反，高收入、CI前增强的听觉和NVC能力、延长的康复时间和剖宫产是这些结果的保护因素。CWMLs更严重是CI后NVC的独立危险因素，而剖宫产、CI前较强的言语能力和Advanced Bionics CI设备是独立的保护因素。本研究强调了将CWMLs严重程度、围产期病史和临床特征纳入术前评估以完善CI候选标准的重要性。所确定的恢复模式进一步指导个性化康复策略，有助于改善PLSND儿童的长期结果。
